Your residency contract almost certainly doesn't have one. Your first attending contract almost certainly does. Somewhere past the salary and the signing bonus sits a paragraph saying that when you leave this job, you can't practice within so many miles of it for a year or two. Sign it unread and you've agreed to the terms of your own exile.
A quick word on the law. In 2024 the FTC finalized a rule banning most non-competes; a federal court set it aside before it took effect, and the agency has since withdrawn it. As of this writing there is no federal ban. State law governs, and it varies wildly: a few states void non-competes for nearly everyone (California, Minnesota, North Dakota, Oklahoma, Wyoming), a growing list restricts them for physicians specifically, and most of the rest enforce them whenever a court finds them "reasonable." Worth knowing too: many hospitals are nonprofits, which the FTC rule would not have reached anyway. Assume yours is enforceable and read it accordingly.
Four things decide how much a covenant actually costs you.
The radius. Miles mean nothing in the abstract. Fifteen miles in a dense metro might mean a longer commute; thirty miles in a smaller market can mean selling your house. Open a map, draw the circle, and see what falls inside it.
The sites. The quiet trap is what the circle is drawn around. "Your primary practice location" is one circle. "Every facility the system operates" is dozens of overlapping circles that can blanket an entire metro. Ask for the first wording.
The trigger. The fairest covenants die if the job does: void if you're terminated without cause. Without that line, a restructuring can end your employment and still hold you to the fence. It is a reasonable ask, and a common one.
The exit price. Some contracts, and a few state laws, build in a buyout: pay a named amount and the covenant releases you. A number converts an unknowable fight into a known cost. If you can't shrink the fence, price the gate.
One more honest thing. Even in states where courts trim overbroad covenants, the trimming happens in litigation, after months and legal fees, while a new employer waits. Almost nobody wins a non-compete fight; the winners avoid signing a bad one. The one moment this clause is fully negotiable is before you sign, which is exactly when it looks least important.